摘要
背景:国内外尚未见运用Bryan颈人工椎间盘置换后对邻近节段(包括邻近一个及两个节段)椎间孔形态改变的研究。目的:分析椎间盘完整、椎间盘切除、Bryan颈人工椎间盘置换和前路颈椎植骨融合钢板内固定后,成人尸体颈椎标本分别在左右侧弯载荷下C5/6椎间孔孔径和面积的变化情况。设计、时间及地点:体外对比观察,生物力学测定实验,于2006-01/02在中南大学材料科学与工程学院国家重点实验室完成。材料:取新鲜人体尸体颈椎标本10具,节段包括C3～T1,剔除肌肉组织保留椎间盘、韧带和关节囊结构的完整。方法:在实验机上分别测量C5/6椎间盘完整、椎间盘髓核摘除、Bryan颈人工椎间盘置换和前路钢板植骨内固定4种状态下以0.25,0.5,0.75,1.00,1.25,1.5N·m的分级载荷加载于标本在侧弯状态时C5/6椎间孔孔径和面积的变化情况。主要观察指标:C5/6椎间孔孔径与面积。结果:侧弯各级加载时,椎间盘完整组、Bryan颈人工椎间盘置换组和前路钢板植骨内固定组的C5/6椎间孔上下径、上前后径、下前后径和面积高于椎间盘髓核摘除组,差异有显著性意义(P<0.05),Bryan颈人工椎间盘置换组高于前路钢板植骨内固定组,差异有显著性意义(P<0.05),其余各组比较,差异无显著性意义(P>0.05)。结论:颈椎间盘髓核摘除后C5/6椎间孔有效空间明显减少,Bryan颈人工椎间盘置换较前路钢板植骨内固定更有助于椎间孔孔径和面积的恢复。
BACKGROUND： There is no study about intervertebral foramen morphologic changes of adjacent one or two segments following Bryan cervical intervertebral disc replacement in China.
OBJECTIVE： To analyze the morphologic alteration of the space of the intervertebral foramina between. C5 and C6 （i.e. C5/6） under different conditions （cervical intervertebral discectomy or no cervical intervertebral discectomy or Bryan cervical disc prosthesis replacement or anterior cervical discectomy and fusion using bone graft and plate fixation） of adult corpse cervical spine samples through different graded-loading-force in lateral conditions.
DESIGN, TIME AND SETTING： In vitro contrast observation and biomechanical detection were performed at the National Key Laboratory of College of Material Science and Engineering, Central South University from January to February 2006.
MATERIALS： Ten fresh adult corpse cervical samples with intact cervical disc and ligament and the facet joint capsule ranged from C3 to T1 segment.
METHODS： The space changes of bone intervertebral foramina of C5/6 undergoing cervical intervertebral discectomy or intact intervertebral disc or Bryan cervical disc prosthesis replacement or anterior cervical discectomy and fusion using bone graft and plate fixation were determined under different graded-loading-force （0.25, 0.5, 0.75, 1.00, 1.25 and 1.5 Nm）.
MAIN OUTCOME MEASURES： The space changes of bone intervertebral foramina of C5/6.
RESULTS： Under the different conditions of graded-loading-force in lateral conditions, the length diameter, superior width, inferior width and space of bone intervertebral foramina of C5/6 in intact intervertebral disc or Bryan cervical disc prosthesis replacement or anterior cervical discectomy and fusion using bone graft and plate fixation groups were significantly higher than cervical intervertebral discectomy group （P 〈 0.05）, and Bryan cervical disc prosthesis replacement group was significantly higher than anterior cervical discectomy and fusion using bone graft group （P 〈 0.05）. No significant differences were found between the other groups （P 〉 0.05）.
CONCLUSION： The space of the intervertebral foramina between C5 and C6 following cervical intervertebral discectomy. Bryan cervical disc prosthesis replacement is more beneficial for recovery of space of the intervertebral foramina than anterior cervical discectomy and fusion using bone graft.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第39期7611-7614,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
